Medical leaders call for more training posts as competition for places increases

Competition for specialty training places in key shortage areas such as general practice and psychiatry is worsening, with rising numbers of applications, a BMJ analysis of NHS data has shown.

Increased applications to general practice and psychiatry, which have historically struggled to recruit doctors, is good news, medical leaders agree. But without an adequate expansion in training posts this enthusiasm will fail to translate into more doctors at the front line of care, they have warned.

The analysis of NHS data shows that in 2024 a total of 59 698 applications were made in England for the 12 743 specialty training posts available at all training levels, giving an overall competition ratio of 4.7.123 This was a substantial increase in the ratio from 3.4 in 2023 (42 766 applications for 12 670 places) and 3 in 2022 (36 563 for 12 075) and continued an upwards curve since 2019, when the ratio was 1.9 (23 040 for 12 175).4

Doctors can apply to as many different specialties as they wish. But the data don’t tell us how many applicants there were in each year or the number who didn’t get a training post. Doctors who fail to secure the specialty training place they want may opt to work as a locally employed (LE) doctor or a locum, …